Outcome of conventional IVF and ICSI on sibling oocytes in patients suffering from teratospermia.

Objective: To compare the outcomes of conventional IVF and ICSI on sibling oocytes.

Design: Retrospective analysis.

Methods: Performance of ICSI on part of the oocytes and IVF on the remaining portion during the same cycle (sibling oocytes).

Patients: 135 couples (141 cycles) with male subfertility or with idiopathic infertility.

Results: Globally, the fertilization rate was not different between the ICSI and IVF, however, in patients with severe teratospermia, it was higher after ICSI (56.2 vs. 44.2 %, p<0.05). The fertilization failure rate was higher in the IVF group than in the ICSI group, globally, (12.1 % vs 2.8 %, p = 0.005), as well in patients with severe teratospermia. In the latter group, a higher number of top quality embryos were obtained after ICSI than after IVF. Of 57 cycles with severe teratospermia, only ICSI-embryos were transferred in 24, while only IVF-embryos were transferred in 11, resulting respectively in 8 and 3 clinical pregnancies.

Conclusion: This study underscores that ICSI is useful in patients with teratospermia. Nevertheless, considering the chances of obtaining a successful fertilization after IVF and lower risk of chromosomal aberrations, we recommend performing both IVF and ICSI on sibling oocytes during the first treatment cycle in patients with teratospermia.